AQA GCSE History: Health and the People: Medicine stands still

What did Medieval doctors base their knowledge on?

The ancients: Greeks, Romans, Islamic Empire

What did Hippocrates invent?

The Theory of Four Humours

What were the Four Humours?

Blood, black bile, yellow bile and phlegm

How did the Humours need to be for a person to be fit and well?

Hippocrates believed that the Four Humours needed to be perfectly balanced

What else did Hippocrates believe in? (2)

- importance of diet and rest

- importance of observing patients and noting their symptoms

Where did Hippocrates live?

Ancient Greece

Where did Galen live?

Rome

Who is older - Hippocrates or Galen?

Hippocrates

What did Galen try to develop?

Developed Hippocrates' idea of the Four Humours

How did Galen suggest treatment should happen in relation to the Four Humours?

He developed the idea of opposites around the Four Humours:

- if the humours were out of balance, you should try and correct them to become well again

How would 'excess' blood be treated by Galen?

Bloodletting to remove it

How would 'excess' yellow bile be treated by Galen?

Vomiting to remove it

How would 'excess' black bile be treated by Galen?

Eating more vegetables and laxatives

How would 'excess' phlegm be treated by Galen?

Breathing in steam, eating hot and fleshy vegetables like chilis (to try and counteract the 'wet and cold' principals of phlegm)

How did Galen try to understand the human body?

He dissected animals

Why was Galen often wrong about the ideas of the human body?

He dissected animals, then applied his findings to the human body (without doing any actual human dissections):

- this was often wrong as animals' and humans' bodies are often different

How was Galen significant in the long term?

His ideas were long upheld by the Medieval Church

Why were Galen's ideas so strongly supported by the Medieval Church?

He believed in one god (monotheism) which the Medieval Christian Church supported

Physician definition and who they treated

- person who went to medical school and was a better trained doctor (although not very knowledgeable or experienced)

- only treated the rich as there were very few of them

Barber surgeon definition and who went to them

- worked in a barber shop and performed dodgy amputations and surgeries. Weren't trained but were more experienced than physicians

- were much more affordable so treated everybody

Midwife definition

- helped with delivering babies

- were often very experienced but lacked training

Quack definition

Conman who would take your money and give you a fake medicine (although were often beneficial due to placebic effects and had ingredients such as alcohol and opioids)

Wise woman definition

Local, cheap woman of the town who was experienced but not trained, would provide herbal remedies

How was Medieval knowledge passed on? (3) Who used these techniques?

- through word of mouth (wise women and barber surgeons)

- by written textbooks and education (eg. Gilbert Eagle's 1230 'Compendium Medicine) (physicians)

- via the Church (monks, some physicians)

Main issues with Medieval surgery (3)

Infection, blood loss, pain

What was a natural hemlock used in Medieval surgery?

A mixture of hemlock and wine

Trepanning definition

Cracking open the skull to relieve pressure

Cauterisation definition

Using a red hot iron or oil on a wound to seal it and prevent blood loss

Surgeries a Medieval doctor could perform (5)

Trepanning, cauterisation, amputation, tooth extraction, blood letting

What Islamic quote encouraged Muslim doctors to find treatments for diseases?

Prophet Muhammad said: 'For every disease, Allah has given a cure'

What was Caliph's 'House of Wisdom'?

- the world's largest library and study centre at the time

- a preservation of hundreds of ancient Greek medical books from Hippocrates and Galen

What was the importance of Islamic medicine? (4)

- Muslims were the first to set up a hospital for the mentally ill, and treated the ill will compassion (unlike Christianity which believed their illness was a punishment from God)

- hospitals were intended to both care for AND treat the illness

- hospitals were for all types of people (men, women, rich, poor, Muslims, non-Muslims)

- doctors were constantly present

What is Ibn Sina's 'Canon of Medicine'?

- a great encyclopedia that covered the whole of ancient Greek and Islamic medicine at the time

- listed the properties of 760 different drugs and had chapters on illnesses such as anorexia and obesity

How is Ibn Sina's 'Canon of Medicine' significant in the long term?

It was the standard European textbook for medicine to teach doctors in the west until 17th century

How was Al-Razi significant? (3)

- wrote over 150 medical textbooks

- successfully distinguished smallpox from measles for the first time

- stressed the need for careful observation of the patient

What were Al-Razi's beliefs on Galen?

Was a follower of Galen; however believed that all students should improve on their teacher and wrote a book called 'Doubts about Galen'

Why did Christians not try to cure illness?

They believed that illness was a sign and punishment from God; therefore trying to stop it would go against God's will

Why did Christians still believe it was important to help the ill?

They believed in following the example of Jesus who healed the sick, so they set up many hospitals

Almshouse definition

Places in towns set up by the donations of the parish that aimed to care for the old and ill via donations of food, money and clothes

How Christianity helped medicine's development (4)

- St. Bartholomew's Hospital in London specialised in the treatment of poor and pregnant women

- many towns had leper houses to isolate and control the disease, 'hospitality' places for travellers and almshouses

- knowledge of herbal remedies

- monks carrying out surgeries and amputations

Who was Roger Bacon

English philosopher who suggested that original scientific experimentation was important (ie. went against the word of Galen) - was arrested for this

What did the Church believe the purpose of a doctor was

To predict the symptoms and duration of a disease, not to heal it

How Christianity hindered medicine's development (6)

- training of doctors only began after 1200

- Church's control of universities hindered research

- couldn't challenge anything that Galen wrote (Roger Bacon)

- Church's idea of doctor's role

- main treatment was prayer

- there were strict rule on hospital admissions: St. John Hospital in Bridgewater specified no pregnant women, no breastfeeding infants

How many hospitals were created in England from 1000-1500?

700 new hospitals created 1000-1500

Who ran Medieval hospitals?

Priests, monks and nuns

Who funded Medieval hospitals?

Charities: wealthier people left endowments in their wills

What did monasteries provide? For how many people?

Monasteries had small hospitals to provide free treatment for the sick and poor

- were very small and generally could fit 12 people

Public health definition

All organised measures to prevent disease and to promote health amongst the population

Privy definition

Communal toilets that were generally located in a shed or outhouse

Examples of Medieval public health (4)

- Medieval towns were built near rivers so people had easy access to fresh water and transport links

- various systems of water supply were set up (as old systems couldn't cope)

- Most towns and private houses had privies with cesspits underneath where the sewage was collected

- cesspits would be dug out annually by gong farmers who would sell it as manure

Issues with instituting new public health rules for mayors

Mayors knew that the improvements would be necessary, but would be costly so taxes would need to increase and this would make them unpopular

Who used river water in the Medieval period?

Everybody: bakeries, breweries, butchers

- but was also used to remove waste which led to contamination of water

What did Parliament's 1388 public health law state?

There would be a fine of £20 (about £20,000 now) to anybody throwing 'dung, garbage or entrails' into water sources

Who were the clergy?

the Church officials

Who funded monasteries?

The Church and charity donations

Where were monasteries often built?

Far away from towns and cities and clergy believed that ordinary people were full of sin and should be avoided

Abbey definition

A larger and more important monastery

Examples of public health in monasteries (4)

- monks sometimes redirected a river to ensure that they had a clean and fresh water supply to their mills, kitchens, bakeries and brew houses

- elaborate systems of pipes to deliver fresh water

- filtering systems were enhanced to remove dirt form the water

- had rooms especially for cleaning where waste water could be emptied into a leaving river

Examples of monks' public health (2)

- heads, faces and feet were washed twice a week as part of a religious settlement

- monks had religious routines of cleanliness

What was the Black Death?

A major disease that spread from Asia into Europe in the 1300s. Spread very quickly and killed about 50% global population (c. 200 million at the time)

When did the Black Death spread to England?

1348

How many people did the 1348 Black Death kill in England

17 million

What did people believe caused the 1348 Black Death?

European doctors blamed it on the misalignment of the stars and planets, on bad air (miasma) and the poisoning of wells by Jews

What impact did the blaming of Jews have?

Led to many attacks against Jews in Europe; but this did not happen in England as all Jews had be expelled by King Edward I

What actually caused the 1348 Black Death?

Outbreak of bubonic plague that spread via fleas living off rats - when the rats died, the fleas spread to humans

How did the 1348 Black Death spread in England? (4)

- crowded towns and cities, people lived close together and knew nothing about contagious disease

- plague could easily spread via air due to coughing

- disposal of bodied was crude and helped spread disease

- littered filth gave rats the ideal environment to breed

How did people try to combat the 1348 Black Death? (4)

- placing a plucked chicken on your body

- staying away from others

- encouraging rest: doctors would promote rest and drinking lots of water

- flagellants: people who would whip themselves to show their love for God and hoping they would be spared

Political impacts of the Black Death (4)

- feudal system collapsed: peasants could leave their village to find work, land and freedom elsewhere

- harsh laws tried to stop peasants' freedom

- new laws (1351 Statue of Labourers) were introduced to try and stop peasants looking for better pay - led to anger

- some nobility changed to animal farming as it required fewer workers -> reduced the supply of crops and bread

Social impacts of the Black Death (4)

- 35% England and Wales' population died. Took 250 years for the population to recover

- new medical discoveries and artistic ideas would later bring a rebirth of culture

- creative works became morbid, image of death was everywhere

- villages were wiped out; animals were left unattended

Religious impacts of the Black Death (4)

- new religious groups were set up

- peasants believed that they could stand up to authority as they had been spared by God

- some peasants accused the clergy of being cowards and deserting the villages

- many Churches had closed down

Economic impacts of the Black Death (4)

- tax increased a lot

- many lords had lost a lot of their money; encouraged their peasants to leave where they worked to find more money

- wages increased by 400% (fewer workers meant higher pay)

- inflation occurred (less food drove prices up)

Why was there a lack of understanding of disease

There was a lack of scientific knowledge due to galen and Hippocrates

Who had a huge influence over medieval medicine

The church

What was the main cause for disease

Gods divine wrath which no one questioned

What did Hippocrates create

Theory of four humours

What was the theory of four homours

The body was made up of four humours and if they were unbalanced, you would fall ill

What did galen create

Theory of opposites

What was the theory of oposites

A way to treat unbalanced humour by eating the opposite humours food

How else was galen important to medicine

He provided info about human anatomy using pig dissections

Why was Galen so popular

• his theories did not require human dissection so church supported it

• Many people were uneducated so it was the best explanation

Why was dissection outlawed

Your body was required to ascend into heaven

What was miasma

A belief that bad air caused disease

How was miasma dealt with

People would carry pomanders filled with pleasant smells

How did people identify which humour was imbalanced

They used their urine and compared it to a urine chart

How was the imbalance of humours treated

Bloodletting and purging

What were the supernatural causes of disease

• gods divine wrath’s

• Astrology

How did astrology cause disease

The alignment of the planets caused disease but the church disliked this

Why was care and treatment ineffective

The church blocked progress and the theory of four humours were incorrect

What were herbal remedies

People believed that natural herbs contained healing powers

What was the example of a herbal remedy

Theriacas but it was sort of ineffective as it was firstly an antidote

How was astrology used to create treatments

Physicians used star charts to give treatment

What was the kings touch

The king had hearing powers as kings had divine right

What were the religious treatments (3)

• praying

• Pilgrimage

• Self flagellation

Why did many Christians refuse to get treatment

As it would be going against gods will as god gave disease

Who were barber surgeons

Barbers who performed surgeries but were not trained

Why did most patients die due to barber surgeons

Shock, blood loss and infection

Who were physicians

Well qualified doctors who only diagnosed patients due to a lack of practical experience

What were apothecaries

They mixed herbal remedies from old books

What was the most popular book apothecaries referred to

Materia medica

Why were apothecaries popular

They were affordable for the poor